The purpose of this 18-month pilot study is to test the effect of a prevention-focused nutritional intervention for nursing home residents. The individualized Nutrition Rx protocol has the potential to improve residents' overall quality of life, and reduce health care utilization. The protocol is based upon Minimum Data Set that was collected and analyzed during a previous study. Nutrition related data were analyzed to identify predictors of protein-caloric malnutrition in nursing home residents. The significant predictors will be used to identify at risk residents who then will be invited to participate in the pilot, prevention-focused intervention. A two-group pre-post design will be used in this pilot study. Residents (N=110) from three nursing homes will be invited to participate. One nursing home will be designated for the intervention group, the other two the care as usual group. Intervention group residents will receive the proactive treatment package that is a six component comprehensive assessment with individualized interventions. Both intermediate outcomes (BMI, serum albumin and prealbumin) and long-term outcomes (quality of life, morbidity, and health care utilization) will be measured. Repeated measures ANOVA will be used to compare the mean endpoints for the two groups. Study findings are anticipated to 1) provide preliminary data about the effectiveness of the intervention to prevent malnutrition in at-risk elders; and 2) provide pilot data for large-scale intervention studies that will improve the nutritional health of at-risk elders living in nursing homes.